For Melanoma, Dacarbazine-Based Combination Therapy vs. Dacarbazine Alone May Improve Outcomes

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According to a new study published in the journal PLoS One, researchers have found that dacarbazine-based combination therapies may improve overall response rates and 1-year survival rates compared with dacarbazine alone patients with advanced metastatic melanoma.

For the meta-analysis, researchers searched through various electronic databases and identified nine randomized controlled trials that included 2,481 patients with malignant melanoma who were treated with dacarbazine with or without placebo, or dacarbazine-based combination therapies. The studies were conducted between 2003 and 2013. Results showed that dacarbazine-based combination therapies were superior to dacarbazine alone in both overall response (combined risk ratio = 1.60; 95% CI: 1.27 - 2.01) and 1-year survival (combined risk ratio = 1.26; 95% CI: 1.14 - 1.39).

However, patients who received dacarbazine-based combination therapies experiences more adverse events than those who received dacarbazine alone. Particularly, nausea (combined risk ratio = 1.23; 95% CI: 1.10 - 1.36), vomiting (combined risk ratio = 1.73; 95% CI: 1.41 - 2.12), and neutropenia (combined risk ratio = 1.75; 95% CI: 1.42 - 2.16) were more common in those who received dacarbazine-based combination therapies.

The findings suggest that dacarbazine-based combination therapies may be more efficacious for patients with advanced metastatic melanoma, but not safer. The researchers suggest that larger, double-blind, placebo-controlled studies are warranted.

For Melanoma, Dacarbazine-Based Combination Therapy Versus Dacarbazine Alone May Improve Outcomes
Dacarbazine-based combination therapies may improve overall response rates.
The objective of this study was to compare the efficacy and safety of dacarbazine (DTIC) with or without placebo and DTIC–based combination therapies in patients with advanced metastatic melanoma. These data suggested that DTIC–based combination therapies could moderately improve the overall response and the 1–year survival but increased the incidence of adverse events.
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